Online Safety Assessment & Individualized Portal Reinforcing Pediatrician Advice

描述（由申请人提供）：这是一个极具创新性的项目，旨在完善一个理论驱动的在线儿童乘客安全预评估，为0-8岁的儿童乘客提供个性化的安全信息，呈现在个性化的门户网站上。为临床医生量身定制的信息，可以在儿童访井期间及时讨论安全措施的障碍，并在门户网站中提供提醒信息，为优化家庭安全措施提供重复提醒和社会网络支持。我们的目标是利用行为改变方面的最新知识来改善儿童乘客和其他安全措施，这些措施可能对新生儿期以后儿童发病率和死亡率的头号原因产生巨大影响。该提案建立在先前工作的基础上，包括1)一个名为CHADIS（儿童健康与发展互动系统）的系统，该系统为目前在全国实践中使用的临床医生提供一系列基于网络的访问前家长问卷，并提供相关的决策支持和资源；2)约翰霍普金斯大学伤害研究与政策中心对家长安全教育的前期研究。在第一阶段，我们将通过认知访谈的迭代过程，完善理论驱动的家长对儿童乘客安全实践的评估，以创建针对儿童年龄、社会人口统计学、父母信仰和感知障碍的量身定制的安全信息。我们还将创建一个基本的家长门户机制，将它们传递给各个家长。在第二阶段，我们将完成一个系统，在检查前提供这些定制的信息，提示临床医生在就诊期间解决感知到的障碍，并通过门户网站提醒和跟进支持，以促进就诊后的安全行为改变，包括创建一个社交网络。门户网站还将包含从家长问卷输入中提取的儿童叙述，以形成可打印的记忆书，吸引回访该网站及其安全信息。第二阶段将包括1200名儿童的随机对照试验（RCT），使用新的评估加上增强型网络系统，新的评估加上标准美国儿科学会的讲义，或常规护理控制实践。ABP安全QI认证和门户的赞助将在第三阶段寻求。

DESCRIPTION (provided by applicant): This is an extremely innovative project to refine a theory driven online previsit assessment of child passenger safety for 0-8 year old children that results in tailored safety messages presented on an individualized portal for the family, messages for clinicians tailored to prompt discussion of perceived barriers to safety practices during well child visits and resulting reminder messages in a portal that provides repeat reminders and social network support for optimizing family safety measures. The goal is to use state of the art knowledge of behavior change to improve child passenger and other safety practices with potentially enormous impact on the number one cause of morbidity and mortality of children beyond the newborn period. The proposal builds on prior work, including 1) a system called CHADIS (Child Health and Development Interactive System) that delivers a comprehensive array of web-based pre-visit parent questionnaires with linked decision support and resources for clinicians now in use in practices nationally; and 2) materials developed from prior research on parent safety education conducted by the Center for Injury Research and Policy at Johns Hopkins University. In Phase 1 we will refine a theory driven parent assessment of child passenger safety practices through an iterative process of cognitive interviews in order to create tailored safety messages specific to child age, sociodemographics, and parental beliefs and perceived barriers. We will also create a basic parent web portal mechanism to deliver them to individual parents. In Phase II we will complete the system for delivering these tailored messages prior to check ups, prompts for clinicians to address perceived barriers during visits, and reminders and follow through supports via the portal to facilitate safety behavior change after the visit including creating a social network. The portal will also contain a reframed narrative of the child derived from parent questionnaire input to form a printable Memory Book which will attract return visits to the site and its safety messages. Phase II will include a randomized control trial (RCT) of 1200 children using either the new assessment plus the Enhanced web-based system, the new assessment but Standard American Academy of Pediatrics handouts, or usual care Control practices. ABP safety QI certification and sponsorships for the portal will be sought in Phase III. PUBLIC HEALTH RELEVANCE: This project will create a theory driven and tested online pre-visit assessment of child passenger safety for 0-8 year old children that results in tailored safety messages presented on a patentable individualized "baby book" type portal for the family, and also messages for clinicians tailored to prompt discussion of perceived barriers to safety practices during well child visits and resulting reminder messages in a portal that provides repeat reminders and social network support for optimizing family safety measures. The goal is to use state of the art knowledge of behavior change to improve child passenger and other safety practices in conjunction with innovative technology to leverage routine child care for purposes of impacting on the number one cause of morbidity and mortality of children beyond the newborn period.